Health bill could slip into next year
By: Chris Frates and Carrie Budoff Brown November 3, 2009 04:53 AM EST

Democrats have blown so many deadlines for getting health reform done this year that insiders are increasingly skeptical they can finish by year’s end — and some even suggest the effort might slip to a new deadline, before the State of the Union address.

The discussions are an acknowledgment that with only two months left in the year, Democrats are still a long way from sending a bill to the president’s desk. The House could take up reform on the floor as early as this week, with a good shot at passing something by Veterans Day.

But in the Senate, Majority Leader Harry Reid is still wrangling with his moderate members to corral 60 votes just to get the debate started. And on Monday, Reid sent a letter to Republicans acknowledging that he is waiting on the Congressional Budget Office’s cost estimates and analysis to finish drafting a bill. Democrats signaled that those estimates would not be ready this week, casting further doubt on their ability to finish reform this year.

Democratic Sen. Kent Conrad said he spoke with CBO Director Doug Elmendorf last week and that it sounded like “it would be quite a while” before the estimates were ready. The news makes a Christmas completion “a challenge,” Conrad said.

Senate Finance Committee Chairman Max Baucus (D-Mont.) also asked Elmendorf when the estimates would be ready. So how long is a while?

“I asked Mr. Elmendorf that question, and I get the same answer: We just don’t know,” Baucus said.

That perception is shared on K Street.“It doesn’t sound to me that they’re ready to go. They still have moderates hanging out there,” said a former Republican Senate leadership aide turned lobbyist.

In order to have a shot at a year-end bill signing, Reid would have to introduce a bill this week and wrap it up by Thanksgiving, giving House and Senate leaders the month of December to reconcile the differences between the two bills and pass the conference report through both chambers.

That scenario is looking more unlikely by the day. In fact, some health care insiders who had once assumed that Reid would introduce a bill by the Veterans Day recess are now bracing for the possibility that its introduction could be delayed until after Thanksgiving. And that speculation has insiders moving the goal posts once again.

Where conventional wisdom once said that any hangover into 2010 would be a momentum-killing death knell for reform, now some insiders believe that reform could survive a bleed over into the New Year as long as both chambers pass reform this year.

“If both bodies have cleared the bill by Jan. 1, then momentum is clearly on the side of the bill,” opening the way for Democratic leaders to come back after Christmas recess with a bill that can pass both chambers and be sent to President Barack Obama’s desk before his State of the Union speech, said a former Democratic leadership aide turned health care lobbyist.

And there are several different ways that Democrats could negotiate a final bill. They could form a conference committee that would reconcile the differences between the two bills into one final piece of legislation.

But there is a way for Democrats to skip the time-consuming conference committee by using the single-bullet maneuver. In this scenario, Reid would insert reform into a House bill that has already passed both chambers, vote it out of the Senate and into the House, where, once approved, it would go straight to Obama’s desk. The maneuver is also called a ping-pong because if changes are made, the bill bounces back and forth between the chambers until both sides pass a final bill.

The procedure has become a common one when passing major legislation through Congress. The housing and bank bailout bills were passed using the single bullet.

“There are already discussions in leadership circles planning out hypotheticals,” said a former senior Democratic congressional aide.

But Democrats dismiss the talk of shifting timelines and procedural maneuvers as gossip. They are sticking, at least publicly, to their year-end timetables. For instance, Democrat Chuck Schumer, a key Senate negotiator, said recently that the whole bill will have to be finished by Christmas.

“We’re going to have to get it done by Christmas,” he said. “We may have to work long weeks.”

Democratic Sen. Ron Wyden said he thinks reform can be completed in 2009, echoing the conventional wisdom on why 2010 would be tougher. “Certainly, when you are in an election year, everybody knows events are seen through a different prism. Everybody is looking at the calendar. There are very different sets of political factors,” he said.

Nadeam Elshami, spokesman for Speaker Nancy Pelosi, left no ambiguity in the Democrats’ timeline.

“For years, Americans have been denied coverage, faced skyrocketing premiums or declared bankruptcy because insurance companies put profits first. These practices by the insurance companies will soon come to an end when we send a bill to President Obama this year to sign,” he said. “The American people deserve nothing less. Republicans have decided to side with the insurance companies and against the millions of Americans who are in need of health care.”

The White House still expects Congress to pass a bill before year's end. “Congress is making extraordinary progress and is on track to enact health insurance reform legislation built on the president’s principles this year,” said Linda Douglass, spokeswoman for the White House health reform office.

Still, not everyone was so sure. Stephanie Lundberg, a spokeswoman for Majority Leader Steny Hoyer, said the House is on track to meet “the goal, not the deadline,” of finishing this year.

“The American people would rather we take the time to get this right than rush to meet arbitrary deadlines. The measure of success is not in dates or deadlines; it will be the delivery of quality, affordable health care for all Americans,” Lundberg said.

Reid spokesman Jim Manley left even more wiggle room when he said, “We want to go the extra mile to make sure we get it right while at the same time we move as quickly as possible.”

Still, the fact remains that Democrats are starting to run out of days in the year. With big chunks of time off planned for Veterans Day, Thanksgiving and Christmas, they will have to seriously pick up the pace to finish by this year.